Going, going, gone: Male pattern baldness a common concern for men

Just a bit in front at first, then more and more until he was left with a ring of hair around the equator, creating a look he calls “the Caesar.”

“I went from a full head of hair to none,” Hawthorne said.

Over the next few years, he came to terms with what nature had in mind for his hair. Now, at 28, the Columbus, Ohio resident shaves his head clean and wears a full red beard.

Male pattern baldness can be traumatic for men. And it strikes a lot of them.

By the age of 30, about 30 percent of men have male pattern baldness; by age 50, about 50 percent join the club. And by age 70, 80 percent of men have some sort of baldness, said Dr. Matthew Kunar of OhioHealth Primary Care Physicians in Dublin.

“Male pattern baldness has been around since the beginning of time. It’s a natural occurring phenomenon,” said David Gail, director of education at the Ohio State College of Barber Styling in Whitehall.

“Most men suffer from it starting out in the crown, working its way towards the front. It’s a very, very common thing.”

So common that men often discuss it with their physicians, said Dr. James Barnes of Mount Carmel Medical Group in Pickerington.

“Men don’t typically come to the office very often, but when they do that’s one of the things they complain about,” he said.

It can cause psychological stress as they come to terms with a change in appearance that some men consider unattractive, Barnes said.

Dr. Aaron Clark said he hears complaints about hair loss about every other week in his part-time practice. He tries to set realistic expectations.

“I usually help them understand that to some extent it’s a ... natural part of the aging process,” said Clark, chief clinical officer for PrimaryOne Health centers and a clinical associate professor of family medicine at Ohio State University.

But doctors say the only thing to worry about with baldness is your ego. While some reports have said that men with baldness are more likely to develop colon cancer or hypertension, Kunar said the association is loose. Men who are concerned about their health should talk to their doctors, he said.

The extent of one’s male pattern baldness likely is influenced by genetics and hormones.

Men who have a father who is bald or balding are five times more likely to go bald than men whose fathers have a full head of hair, Kunar said.

He said another factor is the amount of dihydrotestosterone, or DHT, circulating in one’s body. The DHT binds to receptors in hair follicles and leads to baldness.

Besides urging acceptance, there are a couple things doctors can suggest.

Minoxidil, known commonly by the brand name Rogaine, is available over the counter. It’s a liquid that is massaged into the the scalp.

“It’s effective for not only regrowing hair, but also it’s more effective for keeping you from losing the hair you’ve got,” Barnes said.

He said doctors also can prescribe finasteride (brand name Propecia), an anti-testosterone pill that supplants hormonal hair loss. However, there is some concern that the drug can mask a marker for prostate cancer, and some men are reluctant to use it.

Either way, the key is seeing your doctor as soon as possible.

“You may want to talk about the hair loss before it’s gone, because keeping what you have is easier than regrowing it once it’s gone,” Barnes said.

Clark said that men complaining of baldness generally express an understanding that it’s a natural thing, but still want to try something before they move onto full acceptance. He said many men who try minoxidil or finasteride only do so temporarily because it slows the progression of hair loss but doesn’t lead to the outcomes they want.

There are surgical options, too, doctors say, but they are costly. Some cost $10,000.

There are two main types of surgeries, Clark said, both based on transplanting healthy follicles from the back of the head to bald areas.

This can be done by moving follicles one by one, a procedure that can involve 600 to 8,000 grafts and take four to eight hours.

Another option is a “follicular unit” transplantation, in which a surgeon removes a strip of tissue from the back of the head, gathering good follicles that are then delicately placed in the scalp.

Kunar said, in his practice, complaints have declined over the past 10 years or so as more men embrace baldness or shave their heads for a clean look.

At the College of Barber Styling, the same is true.

Men there, Gail said, don’t complain about hair loss. Instead, they come in for a shave.

“It’s a resolution or resigning to the fact that ‘Hey, I’m going bald, so I’m gonna just shave this stuff and forget about it,’ “ he said.

Hawthorne, a student at the college, said it was rough to lose his hair at first, but now he’s proud to be part of the “bald head club.” Besides, his grandmother and girlfriend think he looks good, he said, so that’s all that matters.

“I just came to the fact that I looked good with a bald head, I would still be able to accomplish anything I could do with long hair as a baldie,” he said. “I’ve just grown to deal with it and make it work.”

— JoAnne Viviano writes about health and medicine for The Columbus (Ohio) Dispatch. Email her at jviviano@dispatch.com or follow her on Twitter at @JoAnneViviano.

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